Recently, the National Healthcare Security Administration (NHSA) discovered a troubling trend during their data analysis: at a pharmacy in Harbin, Heilongjiang Province, 96 insured patients had purchased an astonishing amount of prescription medications, with the highest individual spending exceeding one million yuan over two years. This alarming finding prompted an investigation that took place from August 20 to 26, with reporters from CCTV accompanying a special inspection team.
Three years of taking short-term use medications, totaling over a million in expenses
During the investigation, reporters visited the home of a patient identified through the data screening. Upon checking the NHSA’s medication directory, it was revealed that this patient was taking a drug called Avatrombopag (marketed as Su Ke Xin), a Category B reimbursable drug in China primarily prescribed for chronic liver disease-related thrombocytopenia in adults during preoperative procedures. Typically, this medication is intended for short-term use before interventions.
Calculating based on an average dose of three tablets per day for five days, this patient would only need one box of the medication for their preoperative requirements. However, the patient claimed to have been taking three tablets daily for an extended period, resulting in a shocking total of approximately 160 boxes and 2,400 tablets—worth 714,000 yuan—over two years, consuming the medication for 800 days, which far exceeds the clinically appropriate dosage.
Experts emphasize that ongoing medication, after an intervention, should be based on medical evaluations and prescriptions tailored to the patient’s condition. Thus, how were prescriptions for such excessive dosages acquired? According to the patient, it was their son who handled all the pharmacy visits.
A prescription is required for prescription drugs, prompting patient confusion
It’s astonishing to think that someone could spend over a million yuan on prescription medications without a prescription. Was this indeed the case as the patient and their son described? Accompanying the inspection team, reporters visited several pharmacies, including Jianbai Pharmaceutical, Sipai Pharmacy, Baofeng Pharmacy, and Shangya Kexuan Pharmacy, to investigate.
During interviews at Sipai Pharmacy in Harbin, a peculiar trend emerged. Patients expressed confusion when they were told that they could not purchase prescription medications without a prescription, revealing a gap between regulatory expectations and patient experiences. This discrepancy raised alarms for both the investigative team and the reporters.
Interestingly, prior to the investigation, these pharmacies allowed patients to purchase expensive prescription medications without a prescription. Once the inspection team arrived, the pharmacies suddenly began enforcing a requirement for prescriptions dated the same day.
Uncovering the “black hole” of healthcare fund losses with handwritten prescriptions
The investigation revealed the pharmacies in question were selling special medication, such as Avatrombopag, which is strictly regulated to ensure patient safety. According to regulations, pharmacies must retain valid prescriptions for “special medications.” As the inspection team probed deeper, they requested recent purchasing records from the pharmacies, leading to startling discoveries.
While reviewing documents presented by the pharmacies, investigators found that nearly all the prescriptions were handwritten. These prescriptions listed amounts ranging from nearly a thousand to tens of thousands of yuan. The unexpected prevalence of these casual hand-written prescriptions for high-value special medications raised questions. Many were stamped with seals from Harbin Medical University’s affiliated cancer hospital, prompting inquiries into their authenticity.
The NHSA inspectors raised concerns: “These prescriptions are handwritten, properly stamped, yet we lack the expertise to verify their legitimacy. We need the specialists from Harbin Medical University to assist with this.”
Upon contact, officials from Harbin Medical University asserted, “Our facility no longer issues handwritten prescriptions; we eliminated that practice long ago.”
However, the investigation took a more shocking turn when, while sorting through the documents, they discovered entire books of untouched prescriptions, all filled out with varying medication names and different physician signatures—tallying in the thousands.
According to one NHSA investigator, “These books appear untouched, detailing different medications linked to various doctors. It seems they were pre-prepared, as the handwriting is consistent, yet not all signatures match.”
Special medications like Avatrombopag are usually essential for patients, with limited alternatives, which is why regulatory bodies have stringent processes in place for their purchase, involving a five-step management system. This was designed to prevent misuse of healthcare benefits.
Breakthrough in investigation leads to admission of fraudulent prescriptions by pharmacy staff
After thorough interviews and evidence collection, the NHSA’s investigation yielded a breakthrough. The manager of Baofeng Pharmacy eventually confessed that the multitude of handwritten prescriptions for special medications did not originate from hospitals but were supplied by a pharmaceutical representative.
Furthermore, a pharmacist from Jianbai Pharmacy corroborated that these handwritten prescriptions were merely bought online and then altered.
In total, these four pharmacies in Harbin had amassed over a hundred thousand fake handwritten prescriptions, amounting to over 100 million yuan. The NHSA has since forwarded specific findings related to these pharmacies to local law enforcement.
